What is a high-risk pregnancy?

Your pregnancy is
called high-risk if you or your baby has an increased chance of a health
problem. Many things can put you at high risk. Being called "high-risk" may
sound scary. But it's just a way for doctors to make sure that you get special
attention during your pregnancy. Your doctor will watch you closely during your
pregnancy to find any problems early.

The conditions listed below
put you and your baby at a higher risk for problems, such as slowed growth for
the baby,
preterm labor,
preeclampsia, and problems with the
placenta. But it's important to remember that being at
high risk doesn't mean that you or your baby will have problems.

Your health plan may have its own list of what makes a pregnancy
high-risk. In general, your pregnancy may be high-risk if:

You have a health problem, such as:

Diabetes.

Cancer.

High blood pressure.

Kidney disease.

Epilepsy.

You use alcohol or illegal drugs, or you
smoke.

You are younger than 17 or older than 35.

You
are pregnant with more than one baby (multiple pregnancy).

You have
had three or more
miscarriages.

Your baby has been found to
have a genetic condition, such as
Down syndrome, or a heart, lung, or kidney
problem.

You had a problem in a past pregnancy, such as:

Preterm labor.

Preeclampsia
or seizures (eclampsia).

Having a baby with a genetic
problem, such as Down syndrome.

You have an infection, such as
HIV or
hepatitis C. Other infections that can cause a problem
include
cytomegalovirus (CMV),
chickenpox,
rubella,
toxoplasmosis, and
syphilis.

You are taking certain medicines, such as lithium, phenytoin
(such as Dilantin), valproic acid (Depakene), or carbamazepine (such as
Tegretol).

Other health problems can make your pregnancy high-risk.
These include heart valve problems,
sickle cell disease,
asthma,
lupus, and
rheumatoid arthritis. Talk to your doctor about any
health problems you have.

How will your doctor care for you during your pregnancy?

You will have more visits to the doctor than a woman who does not have a
high-risk pregnancy. You may have more
ultrasound tests to make sure that your baby is
growing well. You will have regular blood pressure checks. And your urine will
be tested to look for protein (a sign of preeclampsia) and urinary tract
infections.

Tests for genetic or other problems also may be done,
especially if you are 35 or older or if you had a genetic problem in a past
pregnancy.

Your doctor will prescribe any medicine you may need,
such as for diabetes, asthma, or high blood pressure.

Talk to your
doctor about where he or she would like you to give birth. Your doctor may want
you to have your baby in a hospital that offers special care for women and
babies who may have problems.

If your doctor thinks that your
health or your baby's health is at risk, you may need to have the baby
early.

What type of doctor will you see for a high-risk pregnancy?

Some women will see a doctor who has extra training in
high-risk pregnancies. These doctors are called maternal-fetal specialists, or
perinatologists. You may see this doctor and your
regular doctor. Or the specialist may be your doctor throughout your pregnancy.

What can you do to help have a healthy pregnancy?

You can help yourself and your baby be as healthy as possible:

Go to all your doctor visits so that you
don't miss tests to catch any new problems.

Eat a healthy diet that
includes protein, milk and milk products, fruits, and vegetables. Talk to your
doctor about any changes you may need in your diet.

Take any
medicines, iron, or vitamins that your doctor prescribes. Don't take any
vitamins or medicines (including
over-the-counter medicines) without talking to your
doctor first.

Take folic acid daily. Folic acid
is a B vitamin. Taking folic acid before and during early pregnancy reduces
your chance of having a baby with a
neural tube defect or other birth
defects.

Follow your doctor's instructions for activity. Your doctor
will let you know if you can work and exercise.

Do not smoke. If
you need help quitting, talk to your doctor about stop-smoking programs and
medicines. Avoid other people's tobacco smoke.

Do not drink
alcohol.

Stay away from people who have colds and other
infections.

Your doctor may ask you to keep track of how much your
baby moves every day.

What symptoms should you watch for?

Like any
pregnant woman, you need to watch for any signs of problems. This doesn't mean
that you will have any problems. But if you have any of these symptoms, it's
important to get care quickly.

Call 911 or other emergency services right away if you think you need emergency care. For example,
call if:

You passed out (lost
consciousness).

You have severe vaginal bleeding.

You
have severe pain in your belly or pelvis.

You have had fluid
gushing or leaking from your vagina and you know or
think the umbilical cord is bulging into your vagina. If this happens,
immediately get down on your knees so your rear end (buttocks) is higher than
your head. This will decrease the pressure on the cord until help
arrives.

Call your doctor now or seek
medical care right away if:

You have signs of preeclampsia, such as:

Sudden swelling of your face, hands, or
feet.

New vision problems (such as dimness or
blurring).

A severe headache.

You have any vaginal bleeding.

You have belly pain or cramping.

You have a fever.

You have had regular contractions (with or without pain) for an hour. This
means that you have 8 or more in 1 hour or 4 or more in 20 minutes after
you change your position and drink fluids.

You have a sudden
release of fluid from your vagina.

You have low back pain or
pelvic pressure that does not go away.

You notice that your baby
has stopped moving or is moving much less than normal.

Organizations

Eunice Kennedy Shriver National Institute of Child Health and Human Development (U.S.)
1-888-320-6942
www.nichd.nih.gov
March of Dimes (U.S.)
www.marchofdimes.com

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